INTRODUCTION TO

OPHTHALMOLOGY
Maj Gen Mazhar Ishaq
Advisor in Ophthalmology
Commandant Armed Forces Institute of Ophthalmology
 OPTHALMOLOGY
OVERVIEW OF THEORETICAL ACTIVITIES

LECTURES CBLS* CPC

MODULE-1 08 08 02
MODULE-2 08 08 02
MODULE-3 08 08 02
MODULE-4 08 08 02
TOTAL 32 32 08
From session 2015 onward, number of CBLS would be 32
 OPTHALMOLOGY
OVERVIEW OF THEORETICAL ACTIVITIES

TOPICS TO BE COVERED

MODULE-1 Lids, Orbit, Conjunctiva, Lacrimal System

MODULE-2 Ocular Surface disorders,Dry Eyes, Cornea, Lens

MODULE-3 Glaucoma, Uveitis, Medical Retina

MODULE-4 Surgical Retina, Squint, Neuro-ophthalmology,

Trauma
LECTURES OF OPHTHALMOLOGY (MODULE - 1 & 2)
Topic of Lectures INSTRUCTORS

LEC-01 Eye Lid - I (Entropion, Ectropion, Ptosis, Maj Gen Mazhar Ishaq
Blephritis,)
LEC-02 Eye Lid- II (Chlazion, Stye, SCC, BCC) Brig Tariq Shakoor

LEC-03 Lacrimal Drainage System (Evaluation, Brig Amir Yaqub /

Dacrocystitis, Canalicular obstruction) Maj Teyyeb Azeem Janjua 
LEC-04 Orbit -I(Evaluation of proptosis, Thyroid eye Brig Amer Yaqub
disease)
LEC-05 Orbit- II (Orbital tumors, Cellulitis) Brig Amer Yaqub

LEC-06 Conjunctiva – I (Evaluation) Col Haroon Javed

LEC-07 Conjunctiva –II (Allergic disorders, VKC) Col Haroon Javed

LEC-08 Conjunctiva- III (Viral, Bacterial, Chlamydial, Col Haroon Javed

Ophthalmia neonatorum)
LEC-09 Dry Eye Diseases (Evaluation of dry eye disease, Brig Rana Intisar Ul Haq
Keratoconjunctivitis sicca)
LEC-10 Corneal Diseases - I (Evaluation) Brig Rana Intisar ul Haq 

LEC-11 Corneal Diseases - II (Bacterial, Fungal) Brig Rana Intisar ul Haq 

LEC-12 Corneal Diseases- III (Viral) Brig Rana Intisar ul Haq 

LEC-13 Corneal Diseases- IV (Keratoconus, Contact lens) Maj Sadia Humayun

LEC-14 Lens- I (Evaluation) Brig Tariq Shakoor

LEC-15 Lens -II ( Congenital , Age related) Brig Tariq Shakoor

LEC-16 Lens -III (ICCE/ECCE/Phaco emulsification) Brig Tariq Shakoor

LECTURES OF OPHTHALMOLOGY (MODULE - 3 & 4)
Topic of Lectures INSTRUCTORS

LEC-17 Lens -IV (Complications) Col Inam ul Haq

LEC-18 Glaucoma -I( Evaluation) Col Haroon Javed

LEC-19 Glaucoma -II ( Classification, POAG, PACG) Col Haroon Javed

LEC-20 Glaucoma -III (Surgery) Col Haroon Javed

LEC-21 Glaucoma -IV (Drugs) Col Inam ul Haq

LEC-22 Uveitis I (Evaluation, Classification, Anterior) Brig Imran Basit

LEC-23 Uveitis II (Intermediate, Posterior) Brig Imran Basit

LEC-24 Retinal Vascular Diseases I (Evaluation, Hypertensive Maj Muhammad Ahsan Mukhtar
Retinopathy, CRAO, BRAO)
LEC-25 Retinal Vascular Diseases II (Diabetic Retinopathy) Maj Gen Mazhar Ishaq

LEC-26 Retinal Vascular Diseases III (CRVO, BRVO) Maj Gen Mazhar Ishaq

LEC-27 Macular Diseases (AMD, RP) Maj Muhammad Ahsan Mukhtar

LEC-28 Retinal Detachment I (Types, Assessment, Prophylaxis) Maj Muhammad Ahsan Mukhtar

LEC-29 Retinal Detachment II (Management ) Maj Gen Mazhar Ishaq

LEC-30 Strabismus (Types, Management) Brig Imran Basit

LEC-31 Neuro Ophthalmology (Cranial nerves palsies) Brig Tariq Shakoor

LEC-32 Ocular trauma (Evaluation, Management) Brig Amir Yaqub /

Maj Teyyeb Azeem Janjua
 CASE BASED LEARNING SCENARIOS (CBLS)
THEME SCENERIO INSTRUCTORS

CBL-1 Drooping of upper eyelid A child, 7 years of age complaints of drooping of both upper Maj Gen Mazhar Ishaq
eyelids. How will you manage the case?  

CBL-2 Watering eye An old man, 67 years of age comes with complaints of Brig Tariq Shakoor
excessive watering from his left eye. How will you manage the  

CBL-3 Protruding Eyes A known hyperthyroid patient comes with complaints of Brig Amer Yaqub
protrusion of both her eyes. How will you manage the case?  

CBL-4 Red Eye I A neonate, 20 days of age is brought in emergency with Brig Imran Basit
complaints of discharge from both eyes and sticky eye lashes in  
the morning. How will you manage?

CBL-5 Red Eye II A known case of Herpes Zoster involving half of forehead and Col Haroon Javaid
scalp is brought in eye OPD with complaints of redness of right
eye and photophobia. How will you manage the case?

CBL-6 Fleshy mass over eyeball A female comes with complaints of some fleshy mass coming Col Inam ul Haq
over her eye. How will you manage the case?

CBL-7 Photophobia A female of 26 years comes with complaints of severe Maj Ahsan Mukhtar
photophobia in her right eye. How will you manage the case?  

CBL-8 Dry eye A 56 years old female comes with complaints of grittiness, and Brig Rana Intisar ul Haq
irritation of both eyes for 3 months. How will you manage the  
patient?
 CASE BASED LEARNING SCENARIOS (CBLS)
THEME SCENERIO INSTRUCTORS

CBL-9 Refractive A female student wants to get rid of her glasses which she is Maj Sadia Humayun
surgery/Contact lenses I using for far vision. What are the available options and how
will you convince her?

CBL-10 Refractive A lady using contact lenses for cosmetic reason comes with Brig Iman Basit
surgery/Contact lenses I I complaints of pain, redness and blurring of vision from her left
eye. How will you manage the case?

CBL-11 Gradual loss of vision I An 17 years old male, comes with complaints of gradual Col Inam ul Haq
deterioration of vision. He is using high refractive error glasses, and
examination with retinoscope shows scissoring reflex. How will you
manage the case?

CBL-12 Gradual loss of vision II An old man, 61 years of age comes with complaints of gradual loss of Maj Ahsan Mukhtar
vision in both eyes, more pronounced in left eye. How will you
manage the case?

CBL-13 Gradual loss of vision III A 42 years old man, known case of open angle glaucoma comes with Col Haroon Javed
complaints of deterioration of vision. How will you manage the case?

CBL- 14 Gradual loss of vision IV A 45 years old female, known diabetic comes with complaints of Maj Ahsan Mukhtar
gradual deterioration of vision in her right eye only. Examination
shows macular pathology. How will you manage the case?

CBL-15 Painful red eye A man, 54 years of age is brought to eye OPD with complaints of Brig Imran Basit
redness right eye, pain and nausea. How will you manage the case?

CBL-16 Sudden loss of vision I A known diabetic, with PDR comes with complaints of sudden loss of Maj Gen Mazhar Ishaq
vision. How will you manage the case?
 CASE BASED LEARNING SCENARIOS (CBLS)
THEME SCENERIO INSTRUCTORS

CBL-17 Sudden loss of vision II A male, 45 years of age comes with complaints of sudden loss of Brig Tariq Shakoor
vision. Fundus examination shows multiple flame shaped
hemorrhages. How will you manage the case?

CBL-18 Sudden loss of vision III A female, 49 years of age comes with complaints of sudden loss of Brig Amer Yaqub
vision. Fundus examination reveal elevated retina with blood vessels
on it. How will you manage the case?

CBL-19 Evaluation of diplopia A middle aged female has diplopia in primary gaze. How will you Col Inam Ul Haq
manage the case?

CBL-20 Misalignment of Eye I A child is brought with complaints of inward deviation of both eyes. Brig Imran Basit
How will you manage the case?

CBL-21 Misalignment of Eye II A child is brought with complaints of outward deviation of right eye. Maj Teyyeb Azeem Janjua
How will you manage the case?

CBL-22 Neuro ophthalmology A female, 54 years of age is brought to eye opd with complaints of Col Haroon Javed
diplopia. Her left eye is down and outward deviated. Pupil is dilated.
How will you manage the case?

CBL-23 Neuro ophthalmology A man comes with history of diplopia in left gaze only. How will you Col Inam ul Haq
manage the case?

CBL-24 Neuro ophthalmology A male, 41 years of age is brought in eye opd with complaints of Brig Imran Basit
blurring of vision of left eye. Examination shows RAPD left eye. How
will you manage the case?
 CASE BASED LEARNING SCENARIOS (CBLS)
THEME SCENERIO INSTRUCTORS

CBL-25 Visual Field Examination A middle aged man is diagnosed as a case of pituitary adenoma. His Maj Teyyeb Azeem
Visual field examination shows bitemporal hemianopia. How will you
manage the case?

CBL-26 Pupillary examination On routine examination, a student is found to have anisocoria. How Col Inam ul Haq
will you manage the case?

CBL-27 Errors of refraction- I A female of 58 years comes to OPD with complaints of poor vision Brig Tariq Shakoor
while reading and doing near work. How will you manage the case?

CBL-28 Errors of refraction –II 18 years old female comes to eye OPD with complaints of decreased Maj Muhammad Ahsan
far vision. How will you manage the case? Mukhtar

CBL-29 Errors of refraction- III A female with poor far vision and refractive error of -4.00 DS both Maj Sadia Humayun
eyes wants to get rid of her glasses. How will you manage the case?

CBL-30 Ocular trauma- I A student, 22 years of age comes with complaints of sudden loss of Maj Gen Mazhar Ishaq
vision after trauma to his left eye. How will you manage the case?

CBL-31 Ocular trauma –II A child, 13 years of age comes with history of chemical trauma in his Brig Tariq Shakoor
right eye. How will you manage the case?

CBL-32 Ocular trauma –III A basketball player comes with complaints of blurring of vision after Brig Amer Yaqub
being hit with the ball. How will you manage the case?
CLINICO PATHOLOGICAL CONF - OPHTHALMOLOGY

MODULE S NO TOPIC FACILITATOR

CPC-1 Ptosis / Entropion / Ectropion Brig Amer Yaqub
MODULE-1  
CPC-2 Corneal ulcer / Pterygiyum / Chalazion Brig Rana Intisar Ul
  Haq
CPC-3 Cataract Brig Tariq Shakoor
MODULE-2  
CPC-4 Glaucoma Col Haroon Javaid
 
MODULE-3 CPC-5 Retinal detachment Maj Gen Mazhar Ishaq
 
CPC-6 Diabetic Retinopathy Col Inam ul Haq
 
CPC-7 Hypertensive Retinopathy/ Maj Ahsan Mukhtar
MODULE-4 Papilloedema/Occlusive Vascular Disorders
CPC-8 Squint Brig Imran Basit
 
 PROGRAM OF CLINICAL TRAINING FOR 4TH YEAR MBBS IN
OPTHALMOLOGY- UNIT - 1
CLINICAL COORDINATOR FOR WARD: BRIG TARIQ SHAKOOR PSYCHOMOTOR OBJECTIVES:
LEARNING OBJECTIVE: 1. Visual Acuity (Children, Adults) 6. Slit lamp examination
1. Take history of ophthalmic patients 2. Visual Fields
3. Refractive Errors 7. Ocular Pharmacology
2. Recognize and describe ocular disorders
3. Recognize the basic features of common Ocular disorders 4. Cataract Examination 8. OphthalmicInstruments
4. Capable of managing common eye diseases 5. Ophthalmoscopy 9. Introduction to Lasers
10. Ocular Investigations

TOPIC/CLINICAL SESSION WITH NAME OF INSTRUCTOR

DAY WEEK-1 WEEK-2 WEEK-3 Week - 4

MON-M History taking Ophthalmoscopy Ocular Pharmacology Ocular Movements

1200-1500 Brig Imran Basit Brig Imran Basit Brig Rana Intisar ul Haq Maj Teyyeb Azeem

TUE-M Clinical Examination Visual Fields – Tonometry Introduction to Lasers

1200-1500 Brig Tariq Shakoor Confrontation Col Inamul Haq Maj MAhsan Mukhtar
Col Haroon Javed
TUE-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-2000

WED-M Visual Acuity Retinoscopy Ophthalmic Visual Field

1200-1500 Brig Rana Intisar Ul Haq Brig Imran Basit Instruments Dr Sheraz Tareen
Maj Teyyeb Azeem

WED-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-2000

THU-M Slit lamp examination Lid Examination Refractive Errors REVISION

1200-1500 Brig Tariq Shakoor Col Haroon Javed Col Inam ul Haq

THU-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-200
PROGRAM OF CLINICAL TRAINING FOR 4TH YEAR MBBS IN OPTHALMOLOGY- UNIT
-2
CLINICAL COORDINATOR FOR WARD: BRIG AMIR YAQOOB PSYCHOMOTOR OBJECTIVES:
LEARNING OBJECTIVE: 1. Visual Acuity (Children, Adults)
1. Take history of Ophthalmic patients 2. Visual Fields 6. Slit lamp examination
2. Recognize and describe Ocular lesions 3. Refractive Errors 7. Ocular Pharmacology
3. Recognize the basic features of common Ocular disorders 4. Cataract Examination 8. OphthalmicInstruments
4. Capable of managing common eye diseases 5. Ophthalmoscopy 9. Introduction to Lasers
10. Ocular Investigations

TOPIC/CLINICAL SESSION WITH NAME OF INSTRUCTOR

DAY WEEK-1 WEEK-2 WEEK-3 WEEK - 4

MON-M History taking Proptosis Examination Squint examination REVISION

1200-1500 Maj Teyyeb Azeem Brig Amer Yaqub Brig Imran Basit
MON-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-200

TUE-M Clinical Examination Pupil Examination Ocular Motility Ultrasonograph

1200-1500 Col Haroon Javaid Maj Sadia Humayun Col Inam ul Haq Dr Sheraz Tareen

TUE-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-2000

WED-M Ptosis Examination Examination of lid Color Vision, Contrast REVISION

1200-1500 Brig Amer Yaqub swellings Sensitivity, Amsler Grid ;
Maj Teyyeb Azeem Brig Rana Intisar ul Haq

WED-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-2000

THU-M Slit lamp examination Examination of lid lesions Acquired retinal diseases TOACS/OSPE
1200-1500 Brig Tariq Shakoor Col Inam ul Haq Maj Muhammad Ahsan
Mukhtar
THU-E Students will practice the learned techniques in wards, and present cases / history to respective specialist
1800-2000
 PROCEDURES TO BE PERFORMED

(each to be performed minimum 4 times)

1. Visual acuity measurement (distant/ near/ pin hole)

2. Fluorescein staining
3. Eversion of upper lid
4. Regurgitation test
5. Digital Tonometry
6. Retinoscopy/ prescribing
7. Visual examination (confrontation method)
8. Ocular motility
9. Pupil examination
10. Ophthalmoscopy
 PROCEDURES TO BE OBSERVED

• Procedures to be observed

1. Cataract surgery
2. Lid surgery
3. Pterygium surgery
4. Orbital surgery
5. Glaucoma surgery
6. Retinal surgery
 ASSESSMENT – PRACTICAL SKILLS

• Case summaries 4/ Unit 3 marks/ summary x 8 24 marks

• Case presentation 1/ Unit 5 marks/ case x 2 10 marks

• Procedures 16 1 mark/ procedure 16 marks

• Total 50 marks
 FINAL ASSESSMENT BY NUST

• Theory 70 marks
• Part – A
• Question 1 MCQs 20 marks
• Questions 2, 3, 4 are Problem Based Questions 26 marks

• Part – B
• Questions 5, 6, 7, 8 are Short Answer/ Essay Questions 24 marks

• Internal Assessment (modular tests + send up) 30 marks

• Total 100 marks

 FINAL ASSESSMENT BY NUST - CLINICAL

• OSCE 30 marks
• Interactive 20 marks
• Observed 20 marks
• Internal Assessment (clinical ward test) 30 marks

• Total 100 marks

• GRAND TOTAL (Theory + Clinical) 200 marks